Myotoxicity of Local Anesthetics and Regeneration of the Damaged Muscle Fibers

@article{Foster1980MyotoxicityOL,
  title={Myotoxicity of Local Anesthetics and Regeneration of the Damaged Muscle Fibers},
  author={Andrew H. Foster and Bruce Martin Carlson},
  journal={Anesthesia \& Analgesia},
  year={1980},
  volume={59},
  pages={727–736}
}
In view of the documented myotoxic effects of the local anesthetic, bupivacaine, a survey of myotoxic effects of seven local anesthetics was conducted. In 70 rats, 200 μl of an anesthetic solution was injected into one tibialis anterior muscle and a control solution was injected into the contralateral muscle. The anesthetics fell into two groups in their effects upon muscle. One group, including 1% procaine, 0.2% tetracaine, 0.5% lidocaine, and 0.75% bupivacaine, produced effects that were… 
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The Long Term Myotoxic Effects of Bupivacaine and Ropivacaine After Continuous Peripheral Nerve Blocks
TLDR
Data show that both drugs induce irreversible skeletal muscle damage in a clinically relevant model, and confirm the exceeding rate of myotoxicity of bupivacaine, but the clinical impact of these long term myotoxic effects still has to be assessed.
The Acute Myotoxic Effects of Bupivacaine and Ropivacaine After Continuous Peripheral Nerve Blockades
TLDR
Compared with bupivacaine, which induces both necrosis and apoptosis, the tissue damage caused by ropvacaine is significantly less severe, and it is concluded that ropavacaine’s myotoxic potential is more moderate in comparison with that of bup Vivacaine.
Biochemical aspects of bupivacaine-induced acute muscle degradation.
TLDR
The results were consistent with the biochemical observation that the main source of cathepsin B in muscle homogenates was infiltrated mononuclear cells, and concluded that the increased lysosomal enzymes may be derived mainly from mon onuclear cells (macrophages), not from muscle lysOSomes, in bupivacaine-induced acute muscle degeneration.
Concentration-dependent bupivacaine myotoxicity in rabbit extraocular muscle.
TLDR
Extraocular muscle injection with full-strength bupivacaine (0.75%) can cause myonecrosis and degeneration acutely, with regeneration appearing by 5 days, followed by some late-stage scar formation, but no long-term effects were observed with bupvacaine concentrations of 0.38% or 0.19%.
Comparison of Myotoxic Effects of Lidocaine with Epinephrine in Rats and Humans
TLDR
The rat provides a good model for the study of local anesthetic-induced myonecrosis, and lidocaine with epinephrine destroyed most of the muscle in which it was injected.
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